Looking for the foot in the door: euphemisms in euthanasia & assisted suicide debate

The recent news concerning Dr Nitschke, Exit International and the suicide death of two men in Australia who were not terminally ill has forced the Australian public to confront the issue of assisting someone to die.

As Herald Sun columnist, Andrew Bolt points out, this is not something new. Nor is the public commentary from Dr Nitschke at the pointy-end of the debate: when a bill is before an Australian legislature.

When Nitschke comments on such bills there's a noticeable cringe factor among state-based supporters of such legislation, with the most common response being that Nitschke's comments 'are not helpful'.

Even though these organisations have always been effectively 'on the same page' as Nitschke in seeking legislative change, what they reject is essentially that Nitschke tells it like it is. To his credit, he shuns euphemisms and advocates directly for any adult to die by euthanasia or assisted suicide whenever they want - regardless of whether or not they have a terminal illness. This stands in direct contrast to the rhetoric and design of most proposed legislation that seeks to limit access to people who are suffering terminal illnesses. They, the state-based groups, argue for the present (the bill under consideration) whilst Nitschke shows the public the future.

This remains the case whether or not the proponents of said bills genuinely seek a limited remit or not. I have met some whom I believe only want such a limited model. But there are others who will clearly understand the incremental nature of such legislation: first get one foot in the door.

So, it is hardly surprising that the man termed 'the other Dr Death', Melbourne Urologist, Dr. Rodney Syme should be bleating on the ABC National news network today saying that he (Nitschke) "represents a maverick who's on the extreme end of the debate."

The report continued:

He (Syme) is eager to make sure the public sees that there is "a huge gap" between his advocacy group and the controversial views of Dr Nitschke.

"He is fundamentally not supported by the organisations who support Dying With Dignity," Dr Syme said.

He would say that. Syme's organisation, the euphemistically titled 'Dying With Dignity Victoria (DWDV)' is currently working towards a push for their agenda at the Victorian State elections later this year. Syme is clearly concerned that the media furore over Nitschke and Exit makes his agenda harder to pursue. To put it bluntly, the stench makes them stink too!

And it is true that some of the state-based groups have distanced themselves from Nitschke on their websites, but as far as I can see, DWDV is not one of them. It's a while back now, but the DWDV website does say that in 1998 Syme's group, 'organized and supported Philip Nitschke's election campaign as an independent in Menzies, standing against Kevin Andrews.'

Sure, people take different directions and relationships change. Apart from the frustration that groups like DWDV must feel when Nitschke effectively rains on their parade, this formerly-known-as a Voluntary Euthanasia Society has, itself changed its tune in recent years. But, like the chameleon, it remains the same creature.

Syme and DWDV now supposedly shun the use of the terms euthanasia and assisted suicide, Syme himself arguing in The Saturday Paper a few weeks ago: 'So, let us argue about voluntary assisted dying, not assisted suicide.' (see my reply here)

As I reported earlier, 'voluntary assisted dying' or simply, 'assisted dying' is the new buzz phrase adopted in the UK and elsewhere in recent years essentially because euthanasia & assisted suicide bills were getting exactly nowhere. This use of euphemisms was recently documented in an excellent article by Jacqueline Harvey on the website The Public Discourse:

Sanitizing Suicide: Killing as Compassion

Physician-assisted suicide advocates learned in the early days of their crusade that people do not like the word "suicide." Prior to Vermont, states that decriminalized the practice did so through carefully crafted ballot initiatives that glossed over the academic literature and its concerns about state-sanctioned killing. These campaigns used clever slogans to suggest that assisted suicide is a positive act, a personal choice, and a matter of compassion for the dying. The Hemlock Society even rebranded itself, changing its name to Compassion & Choices. This suggests that offering an ill person poison is compassionate and that suicide is a legitimate choice for persons with terminal diagnoses. Word choice is critical: a 2013 poll showed a steep 19-point difference when people were asked if they support "assisted suicide" rather than "ending a patient's life."

Although the act is the same, the perception of euthanasia is shrewdly euphemized as "aid in dying" or "death with dignity" to make what is tragic and cruel appear helpful, empowering, and even compassionate. Conversely, such euphemisms imply that pain control and palliative care are somehow lacking in empathy.

The organization now known as Compassion & Choices condemns the term assisted suicide, insisting that there is a distinction between taking one's life when mentally competent and terminally ill, and taking one's life due to depression when not facing a terminal illness. Again, this glosses over the academic literature that shows the extent of untreated depression among those seeking such "aid in dying" and the failure to refer for mental health evaluations in other states that have legalized this practice.

By "aid-in-dying" standards, as long as a person has a prognosis of fewer than six months to live, regardless of the accuracy of that prognosis, it is not suicide for that patient to choose "death with dignity." This, of course, disregards the number of physicians who misdiagnose patients as terminal who may have years to live. Pro-euthanasia groups claim that suicide chosen by those with mental illness ought to be prevented, yet they argue that suicide for those with physical illnesses is a right that others must support.

Unlike abortion advocates, who employ the word "choice" and shy away from the word "death," voluntary euthanasia proponents do not recoil from the words "death" and "dying." Instead, they try to present assisted suicide as a positive form of death; the phrase "death with dignity" implies that natural death is undignified. "Aid" and "dignity" are positive terms, like the appeal to autonomy implicit in the mantra "My Life. My Death. My Choice."

All of this rhetoric conceals the substance of what is being chosen: suicide. It seems that euthanasia advocates know that most people naturally believe that taking one's own life is a tragedy of those without hope.

Every lobby group looking to prosecute its case will use slogans and adopt the kind of language that they hope will resonate and help them achieve their goal. But we're not talking about run-of-the-mill causes, schemes or projects here. This is about death and the protection of citizens from the ultimate injustice.

More than any other debate, euthanasia and assisted suicide demands that a spade be called a spade.